The Missing Care In Obamacare
Dr. Marc Siegel explains in Forbes the reality of Obamacare -- much worse care for many:
Beginning in 2013, 16 million more people will be eligible for Medicaid, but where will they go for care? I don't accept Medicaid now, because it doesn't pay my office expenses, and I won't accept it then, even if the reimbursements increase slightly for two years. Without a network of specialists to refer Medicaid patients to (specialists fees will not be increased), I won't be able to work with it any more in 2013 than I am now.In 2014 patients with pre-existing conditions will be able to obtain insurance no matter whether they are working, healthy, or sick. Many will qualify for federal subsidies. But where will this group go for care? My office practice is already full. And I must admit that once the health reform bill takes hold in a few years, if I do have an opening in my overburdened schedule I will be more inclined to see a patient with a single problem rather than a complex patient. Insurance may cover those with multiple pre-existing conditions but this doesn't mean I will be able to take care of them.
via Paul Hsieh







But, O-care is Free!!!
Didn't you get the message.
Free things are good.
Forget thorny little details about how the free thing or service will be provided.
Once again, we see that P.T Barnum was right.
"This way to the Egress" indeed.
Thomas at May 3, 2010 5:23 AM
I don't think this guy understands what's going to happen to him. He will be required to see everyone, or will be forced to stop practicing medicine. He will either comply either way, or will take the path I anticipate many might: practice on the black market, for cash only.
Short of repeal, which I don't expect to happen, millions of doctors and patients will resort to open defiance of government strictures, in order to give and get timely medical care in the way to which we're accustomed today. They can't throw us all in jail, can they?
cpabroker at May 3, 2010 5:23 AM
No, but if they put a few doctors in prison for refusing to take Medicare patients (Yes, it's not required yet, but Congress will remedy that) then other doctors will fall in line.
The only thing government has going for it is the credible threat of force. And they'll need to use it to create their utopia.
brian at May 3, 2010 6:46 AM
If you think the government can force a doctor to treat you competently, you have never served in the draft era military. Perhaps the term "vicious compliance" might be foreign to you.
Unless you are dying, you'll probably take two aspirin, curse Obama, and go back to bed. Medical tourism, anyone with money? Black market, cash only medical care? Or will your heirs thank you for dying before all your money could be wasted prolonging your life?
Before communism collapsed, the slogan was "They pretend to pay us. We pretend to work." Some people never learn.
MarkD at May 3, 2010 7:14 AM
"practice on the black market, for cash only."
At least then there will be cost transparency.
Cousin Dave at May 3, 2010 7:41 AM
Yes. Acceptance will become compulsory, likely as a proportion of the total number of patients served by the practice.
This whole model appears to be designed to collapse into a single-payer system. It's not viable as a mixed public / private national healthcare scheme. Take a look at some relatively successful examples, like France's, to understand the difference.
I suspect that the Democrats recognize this, which is why they weren't concerned about what was passed. The legislation that was passed is not what will result, so it's not important to dwell on it.
It's a shame, because there are approaches that can address gaps in the market, but our government has chosen infiltrate the entire sector. Perhaps this is their true motive.
Rex at May 3, 2010 7:53 AM
Amy, I think you may have mentioned this before. "Access to a waiting list is not access to medical care."
Jay at May 3, 2010 8:17 AM
Barry said we should be thanking him, well, fuck you very much.
jksisco at May 3, 2010 8:28 AM
The Forbes/Fox News doc says: "And I must admit that once the health reform bill takes hold in a few years, if I do have an opening in my overburdened schedule I will be more inclined to see a patient with a single problem rather than a complex patient."
He's not at all like Hugh Laurie's Dr. House, is he:)
Jody Tresidder at May 3, 2010 12:28 PM
Ah, yes, the ole' " we gotcha by the privates, and you MUST do what we want or else."
Some decades ago, certain vicious feminists determined to destroy all male influence in the US. They assumed men would continue to behave exactly the same, no matter what laws were passed, and thus women would have all the benefits they always had, plus all the new ones.
For a while, they did, but the difference was men still wanted women in their lives, and stupidly imagined the laws did not apply to the Great And Wonderful Me. So, it took a while before men bailed in large quantities from the marriage mistake.
Yet, marriage per 1,000 unmarried women has dropped to half what it was then, and men are leaving the country to get away from the result
of the laws.
Doctors will know instantly they are getting shafted. Older doctors with accumulated assets will do whatever it takes to get away from it, including expat. You will be quite surprised to see what percentage of practicing doctors are in their 50's already and have assets enough to live anywhere they wish.
In a survey last fall, around 33% said they will bail if the law was passed. If only 10% of doctors bail we will be in a terrible mess.
If you study slavery, you find quickly that slavery works only fair for simple repetitive tasks like chopping cotton, and does not work at all for complex and difficult tasks.
irlandes at May 3, 2010 1:07 PM
The difference between a modern liberal and a modern conservative is that the liberal doesn't think you should go to jail except for not following his pet policies.
I've made this point before: there are enough AIDS/frank HIV patients to break any bank, to consume all care. They will no longer be limited to care at home with limited means.
We are where Alexander Tytler said we would be.
Radwaste at May 3, 2010 3:18 PM
Let's see ... he won't take Medicare patients, and anyway his office is full and he's not taking any new patients.
How nice for him, not to have his Hippocratic Oath tested by anything like the profit motive.
I wouldn't bring my fully-insured ass anywhere near this loser.
Steve H at May 4, 2010 10:03 AM
ObamaCare and the Doctor
We should be frightened about the reports of medical care in England, Spain, France, and Japan. But, we don't have to wait for data from ObamaCare. The performance of Medicaid is known now, government healthcare for the poor.
Dr. Zane F. Pollard posted a frightening article describing Medicaid, and by extension ObamaCare.
Medicaid pays for medical services to the poor, and in this case to poor children who face vision impairment or blindness. Regardless, Medicaid denies and delays their care.
Consider that Medicare/caid are intentionally underpaying for the medical care that they mandate, even for the most needy children.
The government is proud of how they are negotiating lower prices for Care/Caid, but they are still going bankrupt with exploding costs.
Some comment links talk about the military health system, that other government run system that serves the people who defend us. They get great care, right? (Wrong)
Andrew_M_Garland at May 4, 2010 10:54 AM
Oh, they'll probably go the same place they've always been going for free, government-mandated care: the Emergency Department.
The big difference between this and the current situation is that the doctors in the E.D. will actually get paid something for a lot of patients that currently law forces them to treat for free.
C at May 4, 2010 10:55 AM
C - What's the difference between getting the government to cover 20% of your losses and getting private insurance to cover 50% of your losses?
Obamacare (which is nothing more than the first step on the road to universal single-payer) ultimately leads to price controls on everything, and if Medicare is anything to judge by, the controlled prices will be set BELOW COST.
Which means all medical practitioners will be forced to work for below cost, and beg Uncle Sugar for a living.
Think about that for a second. People who give up 10-15 years in the prime of their youth to study and accumulate debt, ending up on welfare because the government that will ultimately pay their salary demands that they work for below cost.
Which means, essentially, that people will simply stop becoming doctors and nurses.
brian at May 4, 2010 11:30 AM
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